Project title
以新進磁振掃描及超音波評估肌腱韌帶微結構---探討退化性、糖尿病及心血管疾病相關的組織及代謝變化
Internal ID
MOST104-2314-B002-133-MY3
Principal Investigator
Start Date
August 1, 2016
End Date
July 12, 2017
Investigators
Organizations
Partner Organizations
Evaluation of Tendinous Microstructure by Advanced MR Technique and Ultrasonography---Compositional Change Associated with Degeneration, Diabetes and Atherosclerosis = 以新進磁振掃描及超音波評估肌腱韌帶微結構---探討退化性、糖尿病及心血管疾病相關的組織及代謝變化
Keywords
髕骨肌腱
膝關節
共病
運動治療
機械特性
微循環
超音波
磁振造影
退化性膝關
節炎
節炎
糖尿病
冠狀動脈疾病patella tendon
knee joint
comorbidities
exercise training
mechanical property
microcirculation
ultrasound
shear-wave elastography
MRI
osteoarthritis
diabetes
coronary artery disease
Description
Novel approaches of this research are interested on knowledge in how common comorbidities influence tendon adaptations and its outcomes after training. The patellar tendon, a common tendon of the knee, is responsible for force transmission and elastic energy utilization from the quadriceps, patella to tibia. Therapeutic exercises to populations with ageing or common comorbidities, such as diabetes (DM) or coronary artery disease (CAD), are often recommended with a lower extremity resistance training to reduce their symptoms. However, characteristics regarding microcirculation and mechanical properties, and effects of the exercise training on the patellar tendon in the interested groups of this research project are unclear. This 3-year project aims to investigate the characteristics of the patella tendon of the knee in patients with common comorbidities, and exercise effects for the knee extensor muscle/tendon on the above characteristics. Furthermore, healthy subjects will be also recruited for reference in baseline measurements and comparisons of training effects between healthy and patient populations. For the 1st year, forty healthy individuals (age from 30-70 y/o) will be recruited as a healthy group. These healthy subjects will be randomly assigned into either one group (n=20) with exercise training or another group (n=20) with routine daily activity only. Further, thirty subjects who older than 40 y/o with a diagnosis of knee osteoarthritis greater than grade II (the OA group) will be recruited. For the 2nd year, sixty patients with type 2 DM without known coronary artery disease will be enrolled. For the 3rd year, sixty patients with cardiac catheterization proven CAD will be enrolled. These patients with DM or CAD in the 2nd and 3rd year respectively will be randomly assigned into either a group with exercise training or a control group with routine daily activity only. All subjects in the exercise group, including healthy subjects and patients with DM, CAD, and OA will undergo a 12-week exercise training for the knee extensor muscles at a moderate level of resistance. All subjects in this research will received comprehensive evaluations “before” (pre-) and “after” (post-) the exercise training in their dominant knee; for the OA subjects, the measures will be preferentially performed at the side with a higher radiographic grade. These measurements include functional tests (quadriceps muscle strength, one-leg balance and knee joint proprioception) and measures for the patellar tendon character, such as shear-wave elastography of real-time ultrasound, tendon microcirculation by near infrared spectroscopy, magnetic resonance methods (DCE-MRI, Diffusion-weighted imaging, Diffusion tensor image, Intra-Voxel Incoherent Motion, Ultra-short TE sequence, Chemical Exchange Saturation Transfer). Meanwhile, no exercise training program, except routine daily activity, will be given to the control groups of healthy subjects and patients with DM or CAD during the training period. We aim to investigate new understanding in how different comorbidities affect the adaptation process of the patellar tendon and how well-designed exercise training program may be integrated into the current therapy to optimize the treatments.